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Safety first: Concussion testing to be implemented at area high schools

Dr. Mariecken Fowler gives a presentation
Dr. Mariecken Fowler, from Winchester Neurological Consultants, gives a presentation about concussion testing to coaches, students and parents at Clarke County High School. Dennis Grundman/Daily

Twins Morgan and Aubrey Fletcher attend a seminar
Twins Morgan and Aubrey Fletcher, 14, attend a seminar on concussion testing for high school athletes at Clarke County High School. The sisters have both played soccer and have had concussions. Dennis Grundman/Daily


By Josette Keelor -- jkeelor@nvdaily.com

When parents envision their children succeeding in school sports, they picture touchdowns, goals, awards and even scholarships to take them through college. They know injuries are a possibility -- perhaps a necessity -- of the game, but they probably do not consider that it has the potential to decide a child's future, in high school or even in life.

"Both of my daughters have played soccer ... both have had concussions," Berryville resident Suzanne Fletcher said of her twins, Morgan and Aubrey Fletcher, 14.

The girls and their mother attended an informational meeting at Clarke County High School on Thursday to learn about a program now being instituted in high schools around the region -- Post-Concussion Assessment and Cognitive Testing.

Following a program already in place in professional and college sports, public school officials in Clarke, Warren, Shenandoah and Frederick counties and Winchester are working with Valley Health to introduce ImPACT in high schools, said Mariecken Fowler, a behavioral neurologist with Winchester Neurological Consultants.

"It's the licensed program through the University of Pittsburgh," she said of the test that has been in use for about 10 years around the country. The test, which takes about 20 minutes, evaluates the cognitive abilities of an athlete's brain in order to set a standard for each student. If a head injury should occur over the course of the playing season, the preseason evaluation will serve as a comparison of where the student should be after recovery.

"What this covers is 300 athletes [in each school] to be baseline tested each year," she said.

ImPACT is noninvasive and tests cognitive abilities, such as memory, reaction time, processing speed and concentration.

"It's great that Valley Health can put this together," said Casey Childs, athletic director at Clarke County High School. "[It's a] free service to our kids and to our community."

Three informational sessions already took place around the valley this month; the fourth is planned for tonight at 7 p.m. in the Patsy Cline Auditorium at John Handley High School in Winchester. The plan is to educate families of high school athletes about ImPACT.

ImPACT, which is already mandatory in the National Football League, the National Hockey League and the National Basketball Association, also has begun in colleges and high schools around the country, Fowler said.

"In the past ... concussion was viewed as part of the game," she said.

Someone once told her "I had a headache after every game, and so did all my friends." To them this was normal, she said.

Players -- and often their parents and coaches -- do not recognize the symptoms of a concussion. This is what ImPACT can help schools do, as well as verify when a player has fully recovered from a concussion and can safely return to play.

A concussion is defined as "an alteration in mental status," Fowler said. "There isn't a minor concussion. You can have lasting effects."

About 63 percent of sports-related concussions happen in football, she said, and 10 percent of all contact-sports athletes sustain a concussion every year.

"There's over 300,000 sport-related concussions each year ... and even deaths," Fowler said.

Before using ImPACT, coaches relied entirely on their players' doctors to determine when the student could return to play. Often that decision was based on an across-the-board assumption that concussions heal within a couple of weeks, but Fowler stressed that recovery time depends on the person, on the type of injury and on anatomy. Concussion symptoms, for instance, tend to last much longer in people with a history of migraines, she said.

"[ImPACT is] tailoring the protocol and tailoring to that person," Fowler said. "Hopefully we've learned a better way to take care [of students who have had concussions]."

Fowler said the ImPACT test is more objective, and without it injured students might return to play sooner than they ought to, or they might not recognize symptoms that indicate they have a brain injury.

"I feel much more sure of my decisions when seeing the test performed," Fowler said.

Taylor Stiles, 15, of Berryville, was motivated to learn more about ImPACT after a friend got a concussion while playing football for the freshman team at Clarke County High School this season. His friend has not yet been cleared to play again.

"And that's probably what we all need to know more of," Taylor's father Chris said of concussion awareness.

"[Taylor is] hoping to play football for three more years," said Chris Stiles, who attended Thursday's information session with his son to learn "just more about it, I guess, what the signs are, what you should do.

"It's more in the public eye with the NFL ... it's more in the forefront now."

The biggest threat of concussion, Fowler said, is getting a second concussion after the first one has not fully healed. The ImPACT test makes it much less likely that Second Impact Syndrome would happen, she said.

"I want it in place when my kids are playing sports," Fowler said.

Fairfax County and several schools in West Virginia's Eastern Panhandle have ImPACT testing in place in high schools, she said. "It's mandatory in the NFL. We should have it here."

ImPACT testing initially began this year in Winchester, but was not successful because of lack of information on the program. Families were uncertain about the idea behind ImPACT, and many students could not be tested because they did not have their parents' permission. School officials hope to begin testing for the spring sports.

In the past five years, sports and school officials have learned a lot more about ImPACT, Fowler said.

"There are long-term injuries that can happen, that we can prevent," she said.



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